Device-associated infection rates, mortality, length of stay and bacterial resistance in intensive care units

Device-associated healthcare-acquired infections (DAHAIs) are one of the main threats to the safety of patients,causing patient morbidity, mortality, excess costs and prolonged length of hospital stay (LOS), particularly in intensive care settings of limited-resource countries.Multifaceted infection prevention programs integrating target DA-HAI surveillance methods were proved effective in several United States studies, which showed the occurrence of DA-HAI could be reduced by more than 30%, along with an analogo issue that needs to be addressed in infection control programs in order to prevent the spread of resistant strains through the report of DA-HAI-associated pathogens and their susceptibility to antibiotics.During the last four decades, the United States Centers for Disease Control and Prevention (CDC)’s National Healthcare Safety Network (NHSN) has developed benchmarking data on DA-HAIs in intensive care unit (ICU) patients, which has afforded the International Nosocomial Infection Control Consortium (INICC) an essential insight. It has been the first multi centre surveillance and research network centered on the reduction of the rates of DA-HAI in the ICU and of hospital-wide surgical site infections through tools and resources provided for free to healthcare centers to assist them in with the prevention and control this public health burden through the implementation of infection prevention programs. The INICC network operates by means of an online surveillance system , the INICC Surveillance Online System (ISOS) and a systematic multidimensional approach - the INICC Multidimensional Approach (IMA) - whose effectiveness for the decrease of DA-HAI rates was shown in the scientific literature. The ISOS applies the definitions of HAIs developed by the CDC/NHSN and standardized methodologies, thereby promoting applied research and evidence-based infection prevention practices.Different factors can elucidate the possible reasons for these higher DA-HAI rates compared with the United States CDC’s NHSN and INICC’s reports. As also occurs in other developing countries, weconsider that adherence to infection control bundles in World is variable, there is frequently a low nurse-patient staffing ratio (with a nurse-patient ratio higher than 4:1) and the number of experienced nurses or trained healthcare workers is deficient - which has been demonstrated as significantlyassociated with considerably high DA-HAI incidence rates in the ICU patient. In addition, there is hospital over-crowding. According to World Health Organization standards,there should not be between hospital beds and persons in Iran. The risk of infection of patients hospitalized in ICUs can be reduced though the implementation of surveillance targeted on DA-HAI, because it is successful to focus on characteristics of the burden of DA-HAIs. These surveillance data is necessary to increase ICPS’s sensitivity and aids them to detecting HAIs and avoiding underreporting. In addition, surveillance should be complemented with the performance of other practices for DA-HAI control and prevention.Therefore, INICC has played a crucial by facilitating free infection prevention tools and resources through the use of ISOS, as well as by fostering increasing awareness about the risks posed by DA-HAIs amongst health care professionals.